Active NPI
Christine A Calvin
- School Psychologist
- Bloomington, IN
National Provider Identifier
1396560736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 1061819
- Practice address
- 1111 N Russell Rd
Bloomington, IN 47408-9482 - Phone
- (812) 330-7753
- NPI assigned
- Nov 20, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 1061819 | IN | Primary |
Addresses
Primary practice location
1111 N Russell Rd
Bloomington, IN 47408-9482
Mailing address
6468 E Cox Dr
Bloomington, IN 47408-9517
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1061819 | IN | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1732060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732147200000",
"number": "1396560736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6468 E COX DR",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474089517"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 N RUSSELL RD",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474089482",
"telephone_number": "812-330-7753"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALVIN",
"first_name": "CHRISTINE",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-20",
"last_updated": "2024-11-21",
"certification_date": "2024-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "IN",
"license": "1061819",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.